ICAP M&E Master Slide Deck Data through December 31, 2011

1. ICAP M&E Master Slide Deck Data through December 31, 2011

2. Contents Site Census Slide 3 Care and Treatment Indicators Slide 6 PMTCT Indicators Slide 51 Indicators for TB Screening in HIV Care Settings Slide 61 Indicators for HIV Testing in TB Patients Slide 69 Indicators for HIV Testing and Counseling Slide 74 Indicators for Clinical Laboratories Slide 87

3. What: Ongoing, real-time inventory of all planned, current, and closed ICAP facilities. Supported activities, funding source(s) and their targets are also captured Purpose: To have one up to date master list of facilities, activities, funding sources, and targets that all ICAP staff can refer to for planning and evaluation Site Census

4. Number of selected activities at supported facilities, as of December 31, 2011 Number of facilities Source: ICAP Site Census, February 2011 Note: Some facilities offer more than one activity.

5. Number of facilities by country, as of December 31, 2011 Number of facilities Source:ICAP Site Census, February 2011

6. Number of facilities ever supported by ICAP and transitioned as of September 2011 Number of facilities Source:Source: ICAP Site Census, February 2011 Notes: In transition: A facility may be partially supported by an NGO or MOH but ICAP is still the prime for support and reports directly to Atlanta under MCAP.  Completed transition: ICAP is no longer the prime and there is a new mechanism for supporting the site and reporting to USG (e.g., NGO, MOH or another partner).

7. Care and treatment indicators

8. What: Collects program and facility information on ICAP-supported care and treatment programs annually Purpose: To describe the scope, diversity, and comprehensiveness of ICAP-supported care and treatment programs, and evaluate multi-level factors that influence program performance and patient-level outcomes Program and Facility Characteristics Tracking System (PFaCTS)

9. HIV care and treatment clinics: Geographic location and type of facility (n=796) Percent of clinics Source: ICAP PFaCTS Round 6, February 2011. Note: Clinics for which location and site type are not available are excluded. Urban = officially designated cities with city administration and political bodies; Semi-urban = large and small towns, peri-urban areas, growth points and mining communities; Rural = subsistence and commercial farming areas.

10. Geographic location of HIV care and treatment facilities, by country Percent of clinics Source: ICAP PFaCTS Round 6, February 2011. Note: Clinics for which location and site type are not available are excluded. Urban = officially designated cities with city administration and political bodies; Semi-urban = large and small towns, peri-urban areas, growth points and mining communities; Rural = subsistence and commercial farming areas.

11. Proportion of HIV care and treatment clinics* offering other HIV-related services (n=789) Percent with services Source: ICAP PFaCTS Round 6, February 2011. Note: *“Facility” refers to the larger institution, while “clinic” refers to the unit where care and treatment is provided. **PICT is available at one or more points of service in the facility.

12. Proportion of HIV care and treatment clinics offering patient support services (n=789) Percent with service Source: ICAP PFaCTS Round 6, February 2011. Notes: Facilities with missing data are excluded. ART adherence counseling: Verbal patient education provided by trained personnel at least every 3 months. Outreach: patients who miss clinic follow-up or medication pick up visits are identified and contacted by facility personnel. Nutritional treatment or support for children/infants: provision of nutritional supplements or weaning foods. Nutritional treatment for adults: provision of nutritional supplements or therapeutic foods, e.g. Plumpy’Nut. Food rations: provision of rations, e.g. snacks or food packets to promote ART adherence or household food security.

13. Availability of laboratory assays at facilities (n=796) Percent of facilities Source: ICAP PFaCTS Round 6, February 2011. Note: Laboratory services offered: Within the facility:  specimen collection and testing done within this facility. At another facility: specimen collection done within this facility and testing conducted at another facility or both specimen collection and testing are conducted at another facility.

14. Mean number of full-time health care providers at HIV care and treatment clinics (n=782) Mean number of providers Source: ICAP PFaCTS Round 6, February 2011.

15. Mean number of outreach workers at ICAP-supported HIV care and treatment clinics with outreach programs (n=649*) Mean number of outreach workers Source: ICAP PFaCTS Round 6, February 2011. Note: *Only facilities with outreach programs

16. Proportion of HIV care and treatment clinics offering patient support services over time (n=431*) Source: ICAP PFaCTS Round 6, February 2011. Notes: *Only clinics that submitted all three rounds of data collection are included. ART adherence counseling: Verbal patient education provided by trained personnel at least every 3 months. Outreach: patients who miss clinic follow-up or medication pick up visits are identified and contacted by facility personnel.

17. Proportion of HIV care and treatment clinics where nurses prescribe ARVs, by type of visit (n=790) Percent of clinics Source: ICAP PFaCTS Round 6, February 2011.

18. Care and treatment quarterly aggregate M&E indicators What: Collects information from ICAP-supported clinics on a quarterly basis. Purpose: To describe quarterly and cumulative progress towards targets and overall achievements. 43 collected indicators include care enrollment, ART initiation and enrollment, regimen information, and ART CD4 cohort information.

19. HIV care and treatment services at facilities, as of December 31, 2011 Source: ICAP URS February 2012. Note: Closed facilities includes facilities that have transitioned to MoH, a local NGO, or another implementing partner. Closed facilities also include clinics previously supported through the MTCT+ Initiative.

20. Care and treatment clinics reporting as of December 31, 2011 Source: ICAP URS February 2012.

21. New enrollment in HIV care and treatment, by quarter 58,200enrolling in care 757 clinics Number of new patients Number of clinics 30,889 initiating ART Source: ICAP URS February 2012. Note: New enrollment includes adults and children. New on treatment include patients who transfer in already on ART. Data are only from clinics currently supported and reporting. The country arrows depict when the country began contributing data.

22. Cumulative enrollment in HIV care and treatment 757 clinics 1,018,204 in care 499,194 on ART Number of patients Number of clinics Source: ICAP URS February 2012. Notes: Data are only from clinics supported and reporting. The country arrowss depict when the country began contributing data.

23. Cumulative pediatric enrollment in HIV care and treatment 757 clinics 89,899 in care Number of patients Number of clinics 45,107 on ART Source: ICAP URS February 2012. Note: Includes adults and children. Data are only from clinics currently supported and reporting. The country boxes depict when the country began contributing data.

24. Cumulative enrollment in HIV care, by country(n=1,018,435) DRC Swaziland Côte d’Ivoire Nigeria Tanzania Number of patients Kenya Rwanda Lesotho Ethiopia Mozambique South Africa Source: ICAP URS February 2012. Notes: Data is only from care and treatment clinics supported by ICAP and reporting.

25. Cumulative enrollment on ART, by country (n=534,124) Swaziland Nigeria Côte d’Ivoire Tanzania Number of patients Kenya Rwanda Ethiopia SouthAfrica Mozambique Source: ICAP URS February 2012. Notes: Data are only from clinics supported and reporting.

26. Cumulative patients initiated on ART and their current status, as of December 31, 2011 (n= 499,195) Cumulative ever initiating ART Reported dead Lost to follow-up Number of patients ART patients currently retained in HIV care* Source: ICAP URS February 2012 Notes: Data are only from clinics currently supported and reporting. Data include patients who have temporarily stopped ART for clinical reasons, but are continuing in HIV care.

27. Cumulative enrollment in HIV care and treatment programs, by ART status, age, and sex Total ART enrollment (n= 499,195 ) Total care enrollment (n= 1,018,204 ) 9% 9% 32% 30% Children <15 Men 15+ Women 15+ Children<15 Men 15+ Women 15+ 61% 59% Source: ICAP URS February 2012 Notes: Data is only from care and treatment clinics supported and reporting.

28. Cumulative ART initiation by sex at ICAP-supported facilities in 10 sub-Saharan African countries Men (n= 182,489) Women (n= 316,706) Number of patients Source:ICAP URS February 2012 Notes: Data is only from care and treatment clinics supported by ICAP and reporting.

29. Proportion of all patients ever enrolled in HIV care who ever initiated ART, as of December 31, 2011 Percent of patients Source: URS February 2011 Notes: Data are only from clinics currently supported and reporting.

30. Proportion of all patients ever enrolled in HIV care, by ART status, age and sex, as of December 31, 2011 Percent of patients Source:ICAP URS February 2012 Notes: Data are only from clinics currently supported and reporting.

31. Cumulative enrollment in care, by country, age, and sex, as of December 31, 2011 Percent of patients Source: ICAP URS February 2012 Note: Data are only from clinics currently supported and reporting.

32. Cumulative ART initiation, by country, age, and sex, as of December 31, 2011 Percent of patients Source: ICAP URS February 2012 Note: Data are only from clinics currently supported and reporting.

33. Pregnant women as a proportion of all women initiating ART Over Time Percent of women By Country, October-December 2011 Percent of women Source: ICAP URS February 2012

34. Cumulative pediatric HIV care enrollment, as of December 31, 2011 Percent of pediatric patients Source: ICAP URS February 2012

35. Cumulative pediatric ART enrollment, as of December 31, 2011 Percent pediatric patients on ART Source: ICAP URS February 2012

36. ART initiation among patients eligible for ART in ICAP-supported programs, October-December 2011 Percent patients eligible for ART Source: ICAP URS February 2012 Note: Eligible, but not started: Number in HIV care during the quarter and eligible for ART but NOT started ART by the end of the quarter. Eligible, started: All those who were eligible and started on ART during the reporting quarter.

37. Regimens used by current ART patients, October-December 2011 Source: ICAP URS February 2012 Notes: Data are only from clinics currently supported and reporting.

38. Regimens used by current adult ART patients by country, October-December 2011 Source: ICAP URS February 2012Notes: * In South Africa, D4T-3TC-LPV/r , ZDV-ddl-LPV/r , and ABC-ddl-LPV/r are prescribed as a first-line regimen for pediatric patients. ^ Nigeria only reports regimen information for newly enrolled patients on ART. Data are only from clinics currently supported and reporting.

39. Regimens used by current pediatric ART patients by country, October-December 2011 Source: ICAP URS February 2012 Notes: ^ Nigeria only reports regimen information for newly enrolled patients on ART. Data are only from clinics currently supported and reporting.

40. Proportion of patients with CD4 count at baseline, 6, and 12 months after ART initiation (subset of ART patients*) Percent of patients Source: ICAP URS February 2012 Notes: *Data only included for patients who were followed for 12 months. Data are only from clinics currently supported and reporting.

41. Median CD4 count at baseline*, 6, and 12 months after ART initiation (subset of ART patients**) CD4 Cell Count (cells/ul) Source: ICAP URS February 2012 Notes: Average of median CD4 counts at baseline and 6 and 12 months follow up are presented. * Baseline data is average of matched 6 and 12 month cohort data at baseline. ** Data only included for patients who were followed for 12 months. Data are only from clinics currently supported and reporting.

42. Change in median CD4 count after 6 and 12 months of ART (subset of ART patients*) Change in median CD4 count (cells/µL) Source: ICAP URS February 2012 Notes: Change in average of median CD4 counts at baseline and 6 and12 months follow up are presented. *Data only included for patients who were followed for 12 months. Data are only from clinics currently supported and reporting.

43. Status of ART patients, as of December 31, 2011 (n= 496,544) Rates 7% per year on ART Losttofollow-up 3.5% per year on ART Reported dead Stopped ART .14% per year on ART Source: ICAP URS February 2012 Notes: *Includes patients who transferred out while on ART. Data are only from clinics currently supported and reporting.

44. Reasons for ART discontinuation in ICAP-supported HIV clinics, as of December 31, 2011 Percent of discontinuing patients Source: ICAP URS February 2012 Notes: Excludes patients who transferred out while on ART.

45. PMTCT Indicators

46. PMTCT quarterly aggregate M&E indicators What: Collects information from ICAP-supported facilities on a quarterly basis Purpose: To describe quarterly and cumulative progress towards targets and overall achievements through 32 indicators covering the counseling, testing, HIV results, and ultimately, the treatment of HIV positive pregnant women and their exposed infants.

47. PMTCT facilities reporting as of December 31, 2011 Source: ICAP URS February 2012

48. Number of pregnant women attending ANC and receiving HIV testing, June 2007 – September 2011 Kenya S. Africa Côte d’Ivoire Mozambique, Rwanda, Ethiopia, Nigeria, Tanzania Number of clinics Number of women 1,954 clinics 164,008 HIV tests 202,656 ANC visits Source: ICAP URS February 2012. The country arrows depict when the country started contributing data.

49. Type of ART regimen for PMTCT, by country, October-December 2011 Percent of women Source: ICAP URS February 2012. Notes: Multi-drug regimens include AZT/sd-NVP, AZT/3TC tail postpartum, HAART at 34 weeks.

50. Type of ART regimen for PMTCT, by quarter Percent of women Source: ICAP URS February 2012 Notes: Multi-drug regimens include AZT/sd-NVP, AZT/3TC tail postpartum, HAART at 34 weeks.